In an opinion likely to have far-reaching implications for similar pending litigation, a three-judge panel of the U.S. Court of Appeals for the Federal Circuit on Thursday ruled that the federal government does not owe Moda Health Plan Inc. nor Land of Lincoln Mutual Health Insurance Co. about $200 million and about $76 million, respectively, under the ACA risk corridors program.

General counsel at private equity firms should still be aware of the federal government's unusual decision to pursue claims against a firm based on an alleged fraudulent scheme at its pharmacy portfolio company, legal experts said.

In an interview shortly after his move to the firm, William Chang, a founding member of the U.S. Department of Justice’s Corporate Health Care Fraud Strike Force, also pushed back against the notion that his former team was drastically downsized by the Trump administration.

The D.C. Circuit declined to grant the parties' joint motion to dismiss a case between the Trump administration, House Republicans and a coalition of Democratic state attorneys general over the legality of insurer subsidies under the Affordable Care Act—jeopardizing the agreement the parties reached in the litigation late last year.

Pending felony drug smuggling charges against two former executives at Vireo Health, a medical marijuana dispensary with offices in a few states, highlight the difficulty of operating in an industry where state and federal law are at odds.

National health care law firm WhatleyKallas is once again teaming up with Consumer Watchdog to bring lawsuits, this time against CVS Health, over mandatory mail-order drug programs that allegedly discriminate against HIV/AIDS patients.

Kentucky Gov. Matt Bevin has countersued in federal court in Frankfort, Kentucky, 16 of his residents who are challenging in Washington, D.C., federal court the state’s newly approved Medicaid work requirements.

The U.S. Court of Appeals for the Sixth Circuit on Wednesday upheld a $92,000 verdict for an in-house lawyer at a public utility in Memphis, Tennessee, whose request to work from home for 10 weeks while on bed rest due to pregnancy complications was denied.

ALM talked with Peter Swire, senior counsel at Alston & Bird and privacy and cybersecurity expert at the Georgia Institute of Technology’s Scheller College of Business, about some of the legal and data privacy issues surrounding the new, data-driven health care delivery systems. These include the proposed merger between CVS Health and Aetna Inc., as well as the health initiative that Amazon.com, Berkshire Hathaway Inc. and JPMorgan Chase & Co. recently announced for its employees.

Insurance commissioners in California and Colorado recently announced plans to scrutinize Aetna’s practices for granting and denying health care claims—developments that in and of themselves are unlikely to be deal breakers in the insurance giant’s proposed $69 billion merger with CVS Health, corporate lawyers say.

The top lawyer at the American Red Cross, David Meltzer, has resigned after a news report that he lamented the departure of a senior executive who was pushed out several years ago after an internal investigation of sex harassment allegations.

Dr. Brenda Fitzgerald resigned Wednesday as director of the U.S. Centers for Disease Control and Prevention less than a day after a Politico report that she bought shares in a tobacco company after assuming office—an apparent conflict of interest for the head of the country’s public health agency.

Benevis dental management company and more than 130 of its affiliated Kool Smiles clinics in 17 states have agreed to pay $23.9 million plus interest to settle charges that they fraudulently billed Medicaid for medically unnecessary dental work performed on children.

After a federal judge ruled that the tribal court does not have jurisdiction over the Cherokee Nation’s lawsuit against several pharmaceutical distributors and retail pharmacies over the opioid addiction epidemic, the territory’s attorney general has vowed to continue the legal battle by refiling the case in state court.

The Trump administration, House Republicans and a coalition of Democratic state attorneys general have settled their lawsuit over the legality of insurer subsidies under the Affordable Care Act. The settlement states that the parties agree that a trial judge’s ruling that the House had standing to challenge the payments remains but does not “control” decisions in future litigation over this issue, clearing the way for the states’ separate lawsuit.

Thirty-two nonprofit state and regional hospital associations, represented by Munger, Tolles & Olson, go to court in a new amicus brief that backs an effort to stop HHS from implementing a new rule that would reduce Medicare reimbursements for prescription drugs.

A Barnes & Thornburg partner in Atlanta who faced possible disbarment for fraudulently billing a corporate client tens of thousands of dollars instead will be suspended for two years, the Georgia Supreme Court says. John F. Meyers was a Seyfath Shaw labor and employment partner at the time of the professional conduct violations.

Thaddeus Bereday, the former general counsel at Tampa-based insurer WellCare Health Plans Inc., was sentenced on Nov. 22 to six months in federal prison after pleading guilty in June to one count of making a false statement in connection with a scheme to defraud the Florida Medicaid program.

The American Bar Association has publicly disciplined—with sanctions ranging from letters of noncompliance setting out remedial plans to censure to probation—10 law schools since August 2016 for enrolling students it says are unlikely to graduate and pass the bar.

Dr. John Kapoor, the owner of Insys Therapeutics Inc., maker of a potent opioid medication, pleaded not guilty to federal bribery and racketeering charges on Thursday and asked the magistrate judge to remove his electronic monitoring bracelet.

Several hospital associations and health care systems sued the federal government on Monday to prevent it from implementing a rule that would reduce Medicare reimbursements for prescription drugs bought through a program designed to lower drug costs for hospitals serving low-income patients.

The U.S. Department of Health & Human Services’ Office for Civil Rights is investigating an incident at a Chicago hospital after third-party vendor Experian Health exposed to other health care facilities the personal information of more than 700 patients.

The billionaire founder of an opioid drug manufacturer charged with racketeering and fraud has hired the Boston Nixon Peabody partner who successfully prosecuted mobster James “Whitey” Bulger to defend him.

Nearly two dozen state attorneys general asked a federal judge in California on Wednesday to temporarily block the Trump administration from ending critical subsidy payments to insurers selling coverage through the Affordable Care Act.

Rep. Thomas Marino, R-Pennsylvania, withdrew his name for consideration as President Trump's drug czar, two days after a bombshell from The Washington Post/60 Minutes report about the congressman’s role as chief advocate for a 2016 federal law that weakened the U.S. Drug Enforcement Administration’s control over opioid distributors. Here are a few things to know about the man at the center of the investigation.

President Donald Trump announced Tuesday that Eric Hargan will serve as HHS’ acting secretary, less than a week after the U.S. Senate confirmed him as deputy secretary, the agency’s No. 2 spot. His financial disclosure forms revealed his former clients and his income at the firm.

The federal courthouses in the U.S. Virgin Islands and Puerto Rico have been knocked out by Hurricane Maria, including the one court on St. Croix that was still operating after Hurricane Irma earlier this month.

A federal judge in Texas sentenced a woman with advanced metastatic cancer to 75 years in prison for Medicare fraud last month amid a crackdown on health care fraud by the government. Here's what we learned about the case.

At least 18 top lawyers are among more than 300 entrepreneurs and business leaders who urged Congress to enact legislation to save the Deferred Action for Childhood Arrivals program and the GC of Microsoft pledged to pay for Dreamer employees' legal costs to avoid deportation.

As news of food-safety investigations ramps up, Corporate Counsel recently spoke with Eric Kuwana, a partner at Katten Muchin Rosenman who has defended national retailers, food manufacturers and other supply chain defendants. Kuwana discussed everything from the Chipotle probe to what to expect in this area in the future and how other food and beverage companies can avoid a similar fate.

A federal judge ruled on Aug. 4 that Molina Healthcare, based in California, is owed $52 million from the federal government under the ACA's Risk Corridor Program. Its lead outside counsel talks about the victory and what's next in this and related cases.

Although a federal claims court judge ruled last week that Molina Healthcare Inc. is owed more than $52 million under the risk corridor program, that's not the end of the matter, the company's lead attorney says.

U.S. Attorney General Jeff Sessions announced on Wednesday that the DOJ has formed a unit specifically to combat opioid-related health care fraud by physicians, pharmacies and other health care providers.

Even as 16 state AGs won their fight to intervene in a lawsuit by House Republicans to undermine cost-sharing reductions under Obamacare, a major business group asks HHS to keep them for now for the sake of health insurance market stability.

Even as the Obamacare repeal and replace battle continues in Congress, states are staking steps to limit so-called "surprise" bills patients sometimes receive for care from out-of-network providers in network hospitals.

The New Hampshire Supreme Court recently dealt Big Pharma another blow as it challenges the government's practice of hiring attorneys on a contingency fee basis in litigation accusing the companies of deceptively marketing opioid painkillers.

A growing wave of plaintiffs lawyers are joining state and local governments in filing lawsuits against big pharmaceutical companies blaming them for the prescription opioid addiction epidemic and trying to recover taxpayer funds spent dealing with it.

Some health care practice lawyers weren't ruffled by the passage of the Obamacare repeal bill in the U.S. House of Representatives on Thursday, mainly because they give it little chance of making it through the Senate. But they offered some guidance on what lawyers should be thinking through with clients right now.

This month, to help us unpack major regulatory action in Washington, we led a conversation between two former top federal regulators, William "Bill" Schultz and Ladd Wiley, who served under different presidents.

Judge Lydia Kay Griggsby of the U.S. Court of Federal Claims in Washington, D.C., rejected a lawsuit brought by Blue Cross and Blue Shield of North Carolina for $130 million in payments under the Affordable Care Act's risk corridor program.

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